Nursing Essay The Political Divide and the Moral and Legal Concerns of Medical Marijuana
Medical Marijuana (also known as medical cannabis) is essentially marijuana without the compound THC. THC is a chemical that causes a high if absorbed into ones body. Medical Marijuana has many supposed benefits, but one of the problems is that it is unknown if it can cause harm as well. Usually medical cannabis is prescribed as a pain reliever, but can also be used as an anti-inflammatory drug among other uses. People with Parkinson’s disease can even find some relief from their tremors. Despite showing incredible potential to be a legitimate multi-utilized drug, it remains incredibly controversial due to the many federal regulations that are placed on the drug.
Forty-six of the united states have some type of law providing access to some source of marijuana or hemp products. Medical marijuana is prohibited by law in the remaining four states. Twenty-one of the 50 states have in-depth medical cannabis programs, and 12 states have programs that more strictly regulate access to medical cannabis (Hansen & Garcia, 2019). Despite this, many different political issues concerning medical cannabis continue to surface across the face of the United States (Emerging Public Health Law and Policy Issues Concerning State Medical Cannabis Programs, 2019).
Medical marijuana has been slowly legalised over the country for the last 20 or so years. The first state to take the leap was California in 1996. Since then of course, federal agencies have raised significant law and policy obstacles (Emerging Public Health Law and Policy Issues Concerning State Medical Cannabis Programs, 2019).
One large issue in the laws controlling the distribution, sale, and overseeing of medical cannabis is what is known as conflicts of interest. A conflict of interest may be defined as “a real or seeming incompatibility between one’s private interests and one’s public interests” (Bowling & Glantz, p. 423). An example of a conflict of interest (COI) would be a government employee also having private interest in medical cannabis, like privately owning 15% of a cannabis farm. The reason this is a COI is because a government employee privately having interest may conflict with their public responsibilities.
To avoid conflicts of interest, states that have cannabis programs should have some sort of COI policy, to prevent conflicts from happening. Unfortunately, not many states have these policies in place. Bowling & Glantz (2019) write that, “Only 20% of the states that legalised medical cannabis had COI provisions in their medical cannabis codes…” (p. 423). The remaining 80% of States instead depend on basic guidelines that are used for all “subject matter” (Bowling & Glantz,2019). With no COI policies, many state employees are being dishonest to get extra money, as well as being favored by the state. There need to be set rules and regulations for the interest of medical cannabis, because as Bowling & Glantz (2019) point out, “ Governments should enact cannabis-specific COI policies… to the unique context of bringing cannabis from the black market into the regulated market” (p. 423).
Many people live in states where medical marijuana is legalised, but access to the drug still isn’t easy (Redmond, 2018). In the academic article Emerging Public Health Law and Policy Issues Concerning State Medical Cannabis programs (2019), it is noted that cannabis is still considered a Schedule I drug which means that, “The cultivation, distribution, and use of cannabis are prohibited under federal law.” The federal government has been hindering the growth of medical marijuana research, because it is still technically a prohibited drug. This has not stopped individual states however, from attempting to pass more laws regarding the legality of medical cannabis, in what some might describe as a “defiant manner” (Hannah & Mallinson, 2018). This means that states are attempting to push back on these federal blockades.
Recently, more states have started considering medical marijuana as a possible treatment for the opioid crisis (Emerging public Health Law…, 2019). Many states have been making decisions regarding the policy of medical cannabis for treating opioid use disorder, and at least twelve states, including Hawaii and Maine, have passed laws allowing such. (Emerging Public Health Law and Policy Issues Concerning State Medical Cannabis Programs, 2019).
If more research were to be conducted on medical cannabis, more would be known about it, and thus more states would be more willing to pass laws on medical marijuana. Unfortunately, as stated in the academic article Emerging Health Law and Policy Issues Concerning State Medical Cannabis Programs, “Conflicts between state-based legal authorization and federal prohibitions continue to chill the cannabis industry, inhibit research, and thwart public health regulation. Absent federal guidance, states face significant challenges attempting to regulate this rapidly-expanding billion-dollar industry while simultaneously protecting patients and the public” (2019). This quote is saying that because of all of the conflicting issues in the Medical Marijuana program, and the various laws surrounding it, it will continue to be difficult to complete the research needed to further our knowledge of exactly what medical cannabis does, and how it affects people.
The need to study medical marijuana is great in today’s world. With the knowledge that cannabidiol can ease opioid cravings as well as helping withdrawal symptoms (Lake, 2018), we should be working to further the study of medical marijuana, instead of continuing to push this pressing matter onto the back burner according to response letter Access to Medical Cannabis is Expanding across North America Regardless of the Opioid Crisis—why Not Study If It Could Help? (Lake & Milloy, 2018). In fact, there is the Medical Marijuana Research Act of 2019 (Harris & Blumenauer, 2019). If Congress passes the bill, it will allow more people to know more about medical marijuana, thus increasing the possibility that medical marijuana can be accessed more easily, and people can have more confidence about what they are being prescribed (Harris & Blumenauer, 2019).
Medical marijuana laws have been spreading at an astounding rate, but not everyone always supports these modern ideas. A bill series whose purpose was to “protect VA benefits for veterans who use marijuana, allow the department’s doctors to recommend medical cannabis and expand research into the plant’s therapeutic potential” (Jaeger, 2019, para 1) was written in the beginning months of the year. The U.S. Department of Veterans Affairs however has recently stated that they oppose the bill. Jaeger reports in his article Trump Administration Opposes Bills on Medical Marijuana for MIlitary Veterans that rep. Earl Bluenauer and rep. Lou Correa had both presented acts that would allow medical cannabis to recommended as a prescription for veterans (para. 4), and “require the VA to conduct a clinical study on the benefits and risks of medical marijuana” (2019, para. 5).
The federal government could do more to aid in the legalization/research of medical marijuana. Barnes lists several possibilities including, “They can remove marijuana from schedule 1 of the controlled substances act and place it on another schedule (most likely schedule 2), so that doctors could prescribe it and drug companies would be allowed to distribute it,” and “They can leave marijuana on schedule 1 and either conduct or fund further research on it, preventing current use but making future use more likely” (Barnes, 2000, para. 8). It has been 23 years since California legalised medical cannabis, and yet the federal government has yet to truly approve a research study on medical cannabis.
Medical cannabis is not FDA approved (National Institute on Drug Abuse, 2019) because the federal government has not supported clinical trials on the drug (Emerging Health Law…2019). If the federal government continues to not support large scale clinical trials, it can be assumed that the stigma surrounding medical marijuana will remain a very real challenge for people today.
One of the arguments against the legalization and prescription of medical marijuana is as such: Medical marijuana is harmful, and should not be prescribed because of this (Barnes, 2000). Barnes points out that in some cases, medical marijuana has done some harm, but “these harms are acceptable side effects of a drug which whose benefits sufficiently outweigh its harms (2000, p. 22). Other arguments (Barnes,2000) include that even if the federal government approved a clinical trial, an appropriate placebo for marijuana itself isn’t feasible (p. 25), or that medical marijuana is too difficult a drug for a doctor to prescribe (p.24). The counter argument for the legalization of medical marijuana according to Barnes, however, is that “governmental approval of medical marijuana would ‘send the wrong message’ to the general population and so cause more extensive recreational use of marijuana” (2000, p. 27). Recently however, some states have legalized the recreational use of marijuana (Hansen & Garcia, 2019), thus weakening what used to be a much stronger argument.
Why do people want to try medical marijuana? Perhaps it’s because nothing else that they’ve tried has been successful, and whatever ailment they have bothers them to the point that they are desperate for a medication to alleviate their pain, if not cure it. The drug Marinol is a synthetic version of the chemical THC (Grinspoon, 2000), which is found in the cannabis plant. Patients who smoke cannabis instead of taking this medication may do so for various reasons, which may include, but are not limited to, better performance, lower cost, and less serious side effects (Grinspoon, 2000).
Is there a dilemma for patients that believe medical cannabis is a good option for them (Grinspoon, 2000)? Grinspoon mentions that patients might be afraid of being laughed at, or ignored, because of the stigma surrounding medical cannabis (2000). Gripson also relays the fact that “The attitudes of most physicians toward medical marijuana have been shaped largely by politically imposed ignorance” (2000).
Grinspoon points out another issue, “A half dozen states have passed initiatives which would permit patients to use cannabis with a doctor’s written recommendation, but the conditions are usually so narrowly defined that only a fraction of those who could benefit would be served. Furthermore, the federal government has resisted all attempts by the states to make provisions for legal distribution of medical cannabis” (2000). The point that Grinspoon is aiming at is that while states have made it possible for medical cannabis to be prescribed, the regulations and state of affairs would make it difficult, if not impossible, for the majority of people who could experience elevated states of being (2000).
One case of this happened in New York, where medical marijuana has been legal since 2014 (Redmond, 2018). Redmond writes about her sciatica pain, and how she was desperate to try medical marijuana in the hopes of easing her symptoms (2018, para. 1).
Redmond writes that obtaining a medical marijuana license “proved complicated, time-consuming, costly and infuriating.” She then goes on to announce that “The experience suggested that the state agencies behind it don’t actually want patients to get the drug” (2018, para. 1). Redmond also writes that she has a good relationship with her primary care physician (2018, para. 3), but when she inquired about the process of obtaining a medical cannabis license, her doctor informed her that she could not certify patients legally (2018, para. 4). This was because the clinic was funded federally (2018, para. 4). This enforces the idea that while states can pass laws legalizing medical cannabis, the federal government is still a threat to potential medical cannabis licensees.
Redmond was granted a referral to the Department of Anesthesiology, Perioperative and Pain Medicine in hopes that they would be able to help her get the relief she was seeking (2018, para. 6). It was determined that Redmond was eligible for medical cannabis, but her doctor was sceptical of the drug (para. 7). Her doctor told her that the evidence that medical cannabis could help her was too low (para. 7). Redmond got him to reevaluate, and he told her that it was “a 50/50 chance” (para. 7). All of this was due to the abundance of skepticism in the medical community (para. 8). This was only the tip of the iceberg for author Redmond, who would have to endure many more infuriating circumstances before she finally got her medical marijuana license.
Since the state of California first legalized medical marijuana, great strides have been made across the country, to legalize medical marijuana. Just because many states have laws legalizing medical marijuana, does not mean that everyone who could benefit has access to it. The federal government of the United States continues to impede the ease and assurance of becoming eligible for medical cannabis.